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General NPI Number Information
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NPI Number | 1487066908
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Entity Type | Organization
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Legal Business Name | JOHN W. HAMILTON DDS PC
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Dates
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Enumeration Date | 06/02/2014
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Last Update Date | 06/02/2014
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Provider Practice Location Address
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Address Line | 2204 2ND AVE W SUITE 101
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City | WILLISTON
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State | ND
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Zip | 58801-3485
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Country | US
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Telephone | 701-774-8822
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Fax | 701-774-8823
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Provider Business Mailing Address
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Address Line | 2204 2ND AVE W SUITE 101
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City | WILLISTON
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State | ND
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Zip | 58801-3485
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Country | US
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Telephone | 701-774-8822
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Fax | 701-774-8823
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN W. HAMILTON
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Credential | DDS
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Telephone | 701-774-8822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 1547
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License Number State | ND
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